Avoiding Diabetic Foot Ulcers: What
You Can Do About Them.
Currently, 9.3% or 21.9 million
people have diabetes (CDC, 2014 ). The Center For Disease Control (CDC, 2014),
estimates that in the United States, approximately 8.1 million people are
currently undiagnosed. Who should be
interested in the topic of diabetic foot ulcers? You should, especially if you fit
into one of these categories.
The purpose of this blog is to
educate patients with diabetes as well as family members and/or caretakers
regarding the significance of diabetic foot ulcers. Diabetes is most familiar as it relates to
obesity. There is also a distinct familiarity with the co-morbidity of heart
disease which is directly linked to a deficient diet and sedentary lifestyle. The
risk of death for a person with diabetes is twice that compared to a person of
similar age and background without diabetes (ADA, 2014).
Accordingly, an increase in
mortality can be expected due to (a) large vessel disease, which includes heart
attack and strokes, (b) small vessel disease, which includes the risk of retinopathy
and neuropathy, and (c) nerve damage that primarily affects the lower extremities
(MNT Knowledge Center, 2015). In the foot, nerve damage can be discernible
through tingling, burning sensations, or shooting pain. Unfortunately, it is also
possible to be completely asymptomatic. Over
time, the ability to feel pain is diminished and it is possible for injuries to the feet to go
unnoticed.
Nerve damage, a serious complication
of diabetes due to uncontrolled blood sugar levels, is a primary cause of diabetic
foot ulcers. In the United States, over half of all amputations are caused by a
diabetic foot ulcer (Amputee Coalition Fact Sheet, 2008). A person with
diabetes has a 15-25% lifetime risk of developing a lower extremity wound (Braun,
Fisk, Lev-Tov, Kirsner & Isseroff, 2014).
In 14-24% of cases in the United
States, an ulcer will become serious enough that amputation will be necessary
to save the limb (American Podiatry Medical Association, 2015). In 85% of the
cases, a diabetic foot ulcer precedes the related amputation (American Podiatry
Medical Association, 2015). The risk of death after an amputation approaches 50% at the 5 year mark (Braun et al.,
2014). Surviving an amputation means incurring
tremendous economic burden with the three-year cost of surgery and amputation
approaching $60,000 due to the need for home care and social services (Hinkes,
2009). A person suffering complications of diabetic foot ulcers may
experience added rehabilitation costs, prosthesis expenses, time lost from
work and disability. These are factors that demand a lifetime of repercussions.
Diabetic foot ulcers are largely
preventable. Patient education, blood glucose control and infection control are
all key parts of avoiding complications from foot wounds associated with
diabetes (Braun et al., 2014). The goal
of this blog is to allow patients with diabetes to become active members of the
health care team and work cooperatively with their health care provider to
reduce the incidence and burden of diabetic foot ulcers.
While anyone with diabetes can
develop a foot ulcer, knowing how adverse health issues become problematic can
reduce the incidence. High blood pressure, high cholesterol levels and poor blood
glucose levels greatly contribute to diabetic foot ulcers. Smoking, excessive
alcohol intake and a compromised immune system also factor in. Poor
circulation, foot deformity, such as a bunion or hammer toe, or previous
history of a diabetic foot ulcer are also considered high risk (American
Podiatry Medical Association, 2015).
Keeping nails appropriately trimmed, making
sure shoes fit properly, avoiding walking barefoot and having a foot
examination at least once a year are beneficial. Maintaining a healthy weight
and participating in some form of exercise are extremely useful. Please take
the opportunity to know your risks. Learn what you can do to retain good health
by exploring the importance of an annual foot exam and know why it should
matter to you.
References
American Diabetes Association
(2014). Statistics about diabetes. Retrieved from http://www.diabetes.org/diabetes-basics/statistics/
American Podiatry Association. (2015
). Diabetic wound care. Retrieved from http://www.apma.org/Learn/FootHealth.cfm?ItemNumber=981
Amputee
Coalition Fact Sheet. (2008). Diabetes and lower extremity amputations.
Retrieved from http://amputee-coalition.org/fact_sheets/diabetes_leamp.html
Braun, L., Fisk, W., Lev-Tov, H.,
Kirsner, R., & Isseroff, R. (2014). Diabetic foot ulcer: An evidence-based
treatment update. American Journal of Clinical Dermatology, 15(3),
267-281. http://dx.doi.org/10.1007/s40257-014-0081-9
Centers for Disease Control and
Prevention (2014). National diabetes statistics report. Retrieved
from http://www.cdc.gov/diabetes/pubs/statsreport14/national-diabetes-report-web.pdf.
Hinkes, M. (2009). Diabetes:
Taking steps to prevent amputation. Retrieved from http://lermagazine.com/article/diabetes-taking-steps-to-prevent-amputation
MNT Knowledge Center. (2015). What
is neuropathy? Neuropathy causes and treatments.
Retrieved from: http://www.medicalnewstoday.com/articles/147963.php
Wound Resource. (2015). At-risk
patient: Diabetic foot ulcers. Retrieved from http://www.woundsource.com/patientcondition/risk-patient-diabetic-foot-ulcers
